Trained personnel in Pinellas County’s 911 center route calls as they come into the system.
CLEARWATER – Despite opposition, Pinellas County Commissioners agreed at a Dec. 6 work session to go ahead and put a resolution dealing with 911 priority dispatch on a meeting agenda in January.
The resolution would include current practices and processes regarding handling of 911 calls, as well as phase 1, 2 and 3 of medical priority dispatch.
However, the city of Belleair Bluffs passed a resolution in opposition to phase 3, as did Dunedin, Pinellas Park, Safety Harbor, St. Petersburg, South Pasadena, as well as fire districts in East Lake, Lealman, Palm Harbor and the Pinellas Suncoast. Largo, Seminole and St. Pete Beach passed resolutions in support.
Pinellas County implemented phase 1 of priority dispatch in April 2009. It consolidated 911 functions into one call center for an annual savings of $500,000.
Phase 2 was put into practice December 2010, which reduced ambulance responses by about 5.6 percent a year, resulting in reduced ambulance costs.
Phase 3 would eliminate the use of first responders for minor falls and sick person calls. First responders would continue to go out to all life-threatening calls and all other low severity calls. Staff estimates that first responses would be reduced by about 14,000 calls a year for a 10 percent reduction. They say the change also would reduce complaints from the public and elected officials about dual response to every emergency call.
Phase 3 dispatch is endorsed and approved by the EMS medical director, EMS Medical Control Board, the EMS Management Committee and EMS Advisory Council, which under normal circumstances would be enough to put it into practice.
But the issue of emergency response and transport is a sore subject in Pinellas. Many of those opposed say now is not the right time. They want to delay implementation until after results come back from a study on potential changes to the EMS system.
Commissioner Susan Latvala said implementation of the change to 911 dispatch had nothing to do with the study and agreed with staff that it was time to move forward. She said it could be years before anything came from the study.
Commissioner Ken Welch disagreed, saying the timing could be better due to the continued divide over fire-based transport versus use of a private ambulance provider.
Currently for every 911 call that has a response, four to six personnel in two units go out. Implementation of phase 3 would mean that only two personnel and one unit, an ambulance, would respond to calls about falls and sick persons. Currently, 71.5 percent of people with minor falls or are sick are transported by ambulance.
Staff presented a list of 40 items that would receive ambulance response only under phase 3. It included falls with injuries to body areas describes as “not dangerous” and injuries from falls that happened more than six hours prior. No priority symptoms also made the list as did blood pressure abnormalities, dizziness, fever, insomnia, constipation, ring cut-off requests, deafness, hemorrhoids, hiccups, itching, stuck objects, swallowed objects, rashes, toothaches and infected wounds.
Staff argued that by eliminating first responders from those calls people with serious medical emergencies could be better served. They cited an incident when first responders were on a “minor” call and unavailable for a cardiac arrest, which delayed that patient’s ability to get timely emergency care.
In the past 10 years, the number of 911 calls has gone up by 28 percent. Implementation of phase 3 dispatch would provide cost containment, staff said. They had no estimates of possible savings.
Average response time for a “downgraded” call would be an average of two minutes, 44 seconds longer. If an ambulance can’t respond within 15 minutes, a first responder unit would be sent. If an ambulance needs assistance, a first responder unit would be available
The opposition says that phase 3 dispatch would lower the level of service to which county residents are accustomed.
In the resolution from the city of Belleair Bluffs, the commission says “the dispatch of only a private ambulance to service calls removes the city of Belleair Bluffs’ first responders from providing service to its citizens, thereby privatizing the response to service calls.”
The other cities and fire districts had the same complaint, among others.
Mark Weinkrantz, chairman of the East Lake Fire Commission, said he understood the need for the county to save money, but pointed out that staff was unable to put a dollar figure on savings from phase 3 dispatch.
He said in East Lake emergency calls “weren’t just a number. They are people we’re responsible for. We don’t oppose this as a concept. We ask that you slow down and take a look at the Fitch study and consider those findings in the redo.”
He said the people of East Lake said they wanted three fire stations when only two are required.
“This undermines the wishes of the people,” he said.
Latvala said East Lake was welcome to do more to serve its citizens.
“You can choose to do more,” she said. “You can choose to have fire trucks circulate through your neighborhoods all day.”
Weinkrantz asked how they would know that a call had come in since only Sunstar would receive the call.
Welch said several of those opposed had said they want to know when calls come in for their area.
Bruce Moeller, director of Public Safety Services, said staff was working on a plan and should be able to notify those who request it within about 30 days.
Robert Polk, president of the Pinellas County Fire Chief’s Association, said the association was on record in support of priority dispatch, but not phase 3. He said more consideration should be given to risk management.
“This is not cost savings. This is a decrease in service,” he said.
“I see the sense in the concept,” Commissioner Norm Roche said.
But he agreed with Welch about adding to “the rift.”
“Why create another rift … why feed the fire,” he said.